The severity of acute kidney injury predicts progression to chronic kidney disease.

Abstract:

:Acute kidney injury (AKI) is associated with progression to advanced chronic kidney disease (CKD). We tested whether patients who survive AKI and are at higher risk for CKD progression can be identified during their hospital admission, thus providing opportunities to intervene. This was assessed in patients in the Department of Veterans Affairs Healthcare System hospitalized with a primary diagnosis indicating AKI (ICD9 codes 584.xx). In the exploratory phase, three multivariate prediction models for progression to stage 4 CKD were developed. In the confirmatory phase, the models were validated in 11,589 patients admitted for myocardial infarction or pneumonia during the same time frame that had RIFLE codes R, I, or F and complete data for all predictor variables. Of the 5351 patients in the AKI group, 728 entered stage 4 CKD after hospitalization. Models 1, 2, and 3 were all significant with 'c' statistics of 0.82, 0.81, and 0.77, respectively. In model validation, all three were highly significant when tested in the confirmatory patients, with moderate to large effect sizes and good predictive accuracy ('c' 0.81-0.82). Patients with AKI who required dialysis and then recovered were at especially high risk for progression to CKD. Hence, the severity of AKI is a robust predictor of progression to CKD.

journal_name

Kidney Int

journal_title

Kidney international

authors

Chawla LS,Amdur RL,Amodeo S,Kimmel PL,Palant CE

doi

10.1038/ki.2011.42

subject

Has Abstract

pub_date

2011-06-01 00:00:00

pages

1361-9

issue

12

eissn

0085-2538

issn

1523-1755

pii

S0085-2538(15)54748-0

journal_volume

79

pub_type

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